Understanding Medicare Part C

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costs that Original Medicare doesn’t cover

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Medicare Advantage plans, also known as Part C, include both medical (Part A and Part B) and most include a prescription drug coverage (Part D). Medicare Advantage plans also include extras that often aren’t available with other types of Medicare plans.

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Medicare Part C: Medicare Advantage plans

How it worksWhat it helps coverWhat you payAvailable in these counties

Medicare Advantage plans combine Medicare Part A and Part B benefits, so your hospital and medical coverage are provided under one plan. To enroll in a Medicare Advantage plan, you must be eligible for Medicare Part A and enrolled in Part B. Medicare Advantage plans are usually one of the following:

  • Preferred provider organization (PPO): Allows you to see any network provider without a referral. You also have to live in the service area.
  • Health Maintenance Organization (HMO): Private plans that the federal government pays to administer Medicare benefits.
  • Medicare Advantage prescription drug (MAPD): Medicare Advantage plans that include Part D prescription drug coverage

You get all the benefits of Original Medicare plus “extras” Medicare does not cover. Plans may offer benefits for:

  • Dental
  • Vision
  • Hearing
  • Acupuncture
  • Over-the-counter items and more
  • You must continue to pay your Part B premium in addition to any monthly premium for the Medicare Advantage plan
  • You’ll also pay a portion of some costs, but can save money when you use providers that are in your plan’s network
  • Your Medicare Advantage plan may lower your costs or make your costs more predictable with set copays for some services. You may also have an out-of-pocket maximum for the year.

Anoka • Becker • Beltrami • Benton • Big Stone • Blue Earth • Brown • Carver • Cass • Chippewa • Chisago • Clay • Clearwater • Cottonwood • Crow Wing • Dakota • Dodge • Douglas • Faribault • Fillmore • Freeborn • Grant • Hennepin • Houston • Hubbard • Isanti • Jackson • Kandiyohi • Kittson • Lac qui Parle • Lake of the Woods • Lincoln • Lyon • Mahnomen • Marshall • Martin • Morrison • Mower • Murray • Nicollet • Nobles • Norman • Olmsted • Otter Tail • Pennington • Polk • Pope • Ramsey • Red Lake • Redwood • Renville • Roseau • Scott • Sherburne • Stearns • Steele • Swift • Todd • Wabasha • Wadena • Waseca • Washington • Watonwan • Wilkin • Winona • Wright

Note: Medicare Cost plans are not offered in these counties

What you should know

  • PPOs offer more flexibility and choice by offering a broad network of providers, and you don’t need referrals to see specialists in the network
  • Benefits and provider networks differ from plan to plan because coverage is offered by private health insurance companies
  • You can travel for up to twelve months in the United States and receive in-network coverage for medically necessary services from any provider that accepts Medicare assignment

 

 
Medicare Cost plans

How it worksWhat it helps coverWhat you payAvailable in these counties
Medicare Cost plans provide additional coverage to help pay for expenses Original Medicare doesn’t cover. Some Cost plans also offer optional Part D prescription drug coverage. To be eligible for a Cost plan, you must be eligible for Medicare Part A and enrolled in Part B.
  • Medicare Cost plans include all the benefits of Original Medicare and help pay the deductibles, copays and coinsurance Original Medicare doesn’t cover
  • If you choose to include prescription drug coverage, your plan also helps pay the cost of your medications
Costs vary depending on the plan you choose. You must continue to pay your Part B premium, along with monthly Medicare Cost plan premiums, copays and coinsurance.

Aitkin • Carlton • Cook • Goodhue • Itasca • Kanabec • Koochiching • Lake • Le Sueur • McLeod • Meeker • Mille Lacs • Pine • Pipestone • Rice • Rock • Sibley • St. Louis • Stevens • Traverse • Yellow Medicine

Note: Medicare Advantage (Part C) plans are not offered in these counties

What you should know

  • Typically, you can see any in-network provider without a referral. If you choose an out-of-network provider, you may only receive Original Medicare coverage for those services.
  • You can travel for up to nine months in the United States and receive in-network coverage for medically necessary services from any provider that accepts Medicare assignment
  • Costs incurred under the travel benefit apply toward your out-of-pocket maximum

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Blue Cross Advisor Katie Giziewski

Our Blue Cross Advisors are here to:

  • Help you learn about Medicare basics and our plans
  • Assist you in finding a plan that meets your needs
  • Help you enroll in a plan

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Learn the essentials of Medicare

Use this guide to make understanding Medicare easier. It covers the essentials you'll need to know, like the four parts of Medicare, when to enroll and how to avoid penalties.

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